Could $2.3 Million Solve a Stubborn Orthopedic Riddle?

The National Institutes of Health (NIH) has decided to award $2.3 million to a research team at California-based UC Davis Health to, perhaps finally, answer the very stubborn question of how much activity should osteoarthritis (OA) patients have after a joint injury in order the optimize healing and return to pre-OA or pre-injury activities.

It’s a notably stubborn problem, as principal investigator Blaine Christiansen, Ph.D., associate professor of orthopedic surgery at UC Davis Health, explained to OTW, “There is no consensus in the medical field about how much activity patients should have in the first few days or weeks after a joint injury, and almost no consideration was given to how this activity level could affect the risk of developing osteoarthritis.”

The goal of the UC Davis team will be to “Investigate how joint loading (exercise) or unloading (rest) affects osteoarthritis progression and also to investigate biomechanical interventions for preserving joint health after an injury. Our goals are to develop biomechanical interventions for treating joint degeneration in the immediate post-injury phase and determine the best ways to use those interventions to reduce the negative long-term effects of injury.”

In one of the UC Davis’s previous studies in mice, the team found that “…unloading an injured knee joint following ACL injury reduced early inflammation in the joint and slowed the formation of osteophytes (bone spurs) at later time points. This led us to believe that the amount of rest vs. activity in the first few days or weeks after a joint injury could have long-lasting effects on the development of post-traumatic osteoarthritis.”

Finally, said Dr. Christiansen, “I think at this point the most important thing to determine is how much activity is most effective. There is some evidence showing that a modest amount of slow walking is beneficial following a joint injury, but too much or too intense activity can increase inflammation in the joint and possibly even make injuries worse. Finding the right balance between activity and rest is a key first step in developing effective therapies.”